Disposable Patient-controlled Analgesia Research Articles

A disposable device for patient-controlled intravenous analgesia: Evaluation by patients, nursing and medical staff

Summary The acceptability of a disposable patient-controlled intravenous analgesia device (Go Medical Industries, Subiaco, Western Australia) was evaluated by questionnaire. Separate questionnaires were completed by 20 patients (response rate 100%) who had recently used the device after a variety of surgical procedures; by 41 nurses (82%) on post-surgical wards and by 11 anaesthetists (73%), all of whom were staff familiar with the device. Patients reported a high level of satisfaction with the device [median (Q1–Q3) score 90 (80–100)], reporting it to be easy to use for post operative analgesia. Staff responsible for the device also reported a high level of satisfaction [score 80 (70–90) for anaesthetists and 90 (80–100) for nurses] and particularly liked its light weight and portability. Concerns were expressed about the potential for tampering and the reliability of the device, with occasional equipment failures reported. We conclude that this lightweight disposable patient-controlled analgesia device was easy to use and was acceptable to both patients and staff.

A Clinical Study to Evaluate the Safety and Efficacy of a Patient-controlled Analgesia Pump in Post-surgical Patients

Background: The disposable patient-controlled analgesia (PCA) devices are convenient for portability and management. An ideal PCA can be developed as an electronic device with various functions of safety and control. Recently, Accumate 1000Ⓡ was developed as an electronic pump in Korea, and has passed the relevant laboratory criteria of safety and efficacy. We conducted a clinical study on the safety and efficacy when the device is applied to patients. Methods: Fentanyl 1,500μg, ketorolac 180 mg, and ondansetron 8 mg were used for PCA. Continuous infusion rate, bolus dose, and lockout time were set at 1 ml/h, 1 ml, and 15 min, respectively. Fifty patients were monitored for 48 h. The safety of Accumate 1000Ⓡ was evaluated by backflow and siphonage, auto-clamp function, and lockout time intraoperatively. The efficacy was evaluated by the accuracy of bolus and total infused dose, and the satisfaction rates of patients and users. Results: Backflow and siphonage did not occur, and the auto-clamp function was excellent. There was no bolus infusion during lockout time, and the bolus dose was infused accurately after lockout time. For the accuracy of the total infused dose, the mean and median value of performance error between the infused and target doses were －0.55%, and －0.29%, respectively. Noise, button sense, and convenience of cable were rated as satisfactory by 90%, 78%, and 84%, of patients respectively. Conclusions: The safety and efficacy of Accumate 1000Ⓡ were established by clinical trial. We can provide patients with the more precise and optimal analgesia. The history of drug infusion can be used as research data. (Korean J Anesthesiol 2007; 52: 161～5)

Comparison between a disposable and an electronic PCA device for labor epidural analgesia

The aims of the present study were (1) to investigate if a disposable patient-controlled analgesia (PCA) device can be used for labor analgesia and (2) to evaluate the device by midwives and parturients. Forty healthy parturients were divided into two groups and received combined spinal epidural analgesia for labor pain relief. Following intrathecal administration of 3 mg ropivacaine and 1.5 microg sufentanil, either a disposable PCA device (Coopdech Syrinjector; Daiken Medical, Osaka, Japan) or an electronic PCA device (IVAC PCAM PCA Syringe Pump; Alaris, Basingstoke, UK) was connected to the epidural catheter, and 0.15% ropivacaine with sufentanil 0.75 microg/ml was used for continuous infusion and PCA. For an electronic PCA device, continuous infusion rate, bolus dose, lockout time, and hourly limit were set at 4 ml/h, 3 ml, 15 min, and 16 ml, respectively. For a disposable PCA device, continuous infusion rate, bolus dose, and an hourly limit were set at 4 ml/h, 3 ml, and 16 ml, respectively, but lockout function was not available. No differences were observed between the groups concerning demographic data, obstetric data, and outcome of labor. Anesthetic requirements (disposable, 9.7 +/- 4.7 ml/h; electronic, 8.2 +/- 4.0 ml/h) and VAS score during the delivery (disposable, 26 +/- 25; electronic, 21 +/- 22) were similar between the groups. Midwives praised the disposable PCA device as well as the electronic one. The present results imply that the disposable PCA device can be an alternative to the electronic PCA device for labor analgesia.

Pharmaco-economic evaluation of a disposable patient-controlled analgesia device and intramuscular analgesia in surgical patients

Pharmaco-economic evaluation of a disposable patient-controlled analgesia device and intramuscular analgesia in surgical patients

Laboratory Evaluation of the Baxter Patient-Controlled Analgesia Infusor System

The purpose of this study was to determine the accuracy of bolus-demand volumes obtained from the Baxter Patient-Controlled Analgesia Infusor System, a disposable patient-controlled analgesia device. An automated system was used to make demands in a pattern designed to simulate those made by a patient in the first 24 postoperative hours. Following this, a pattern of varying short interdemand intervals was used to evaluate performance of the device when demands were made near the nominal lockout interval of 6 min. Finally, a prolonged array of short interdemand intervals was used to evaluate performance as the reservoir of the devices became exhausted. Ten devices were tested. One device failed; after 70 min of testing the reservoir burst. The mean delivery of the remaining nine devices for the first 24 h of testing was 92.6% of nominal (SD = 3.9%). Evaluation near the nominal lockout interval revealed a departure of delivered volume from nominal (worst = 73.9% at an interdemand interval of 6 min). As the reservoir became exhausted, delivery increased to a maximum value, ranging from 118% to 137% of nominal, before falling to zero. In general, the devices performed consistently and the departures from nominal delivery were not considered to be of clinical significance.

Laboratory Evaluation of the Go Medical PCI: A Disposable Patient-Controlled Analgesia Device

A low-cost, disposable patient-controlled analgesia device was tested using a computer-controlled, automated testing station designed to simulate clinical use. Five devices were tested and delivered a mean bolus dose size of 95% of nominal, although one device achieved only 85% of nominal. Delivery was lowest immediately following an eight-hour interval during which no demands were made. Further development and evaluation of this interesting device is warranted.

EVALUATION OF A DISPOSABLE PATIENT-CONTROLLED ANALGESIA DEVICE IN CHILDREN

A disposable patient-controlled analgesia (PCA) device was evaluated in 20 children after major abdominal, urological and orthopaedic surgery. All patients were given a high dependency level of nursing care in general wards. Efficacy (as assessed by hourly pain scores) was comparable to that achieved in a matched control group of 20 children who used the Graseby PCA system. Safety was confirmed by monitoring arterial oxygen saturation, sedation scores and ventilatory frequency. Morphine consumption was similar with the two techniques, but varied widely between patients. The disposable device has a complementary role to play in the provision of a comprehensive pain relief service for children.